What to Say in a “Thinking of You” Card

Image result for Jimmy Fallon GIF Thank You Notes

Why “Thinking of You?” Is So Powerful

Hearing those three simple words can change someone’s perspective, make their day better, and assure them they are not alone in the world. Think of a time when someone reached out to you to say they were thinking of you. Do you remember how it made you feel? If someone on your mind could use a lift, consider sending them a Thinking of You card.

Three Simple “Thinking of You” Rules

Not sure what to write for a thinking of you card? Fear not. This article will provide some ideas to help you get your thoughts on paper. Here are three simple rules by Peter Frigeri:

  • Keep it short and avoid rambling (which can lead to saying something wrong or diluting the message). A sentence or two is often all that’s needed.
  • Keep it simple. Go for clear over clever or funny. And don’t feel you have to use poetic, flowery language if that’s just not you.
  • Keep it appropriate. Remember who you’re writing it for and stay authentic to the relationship you have with the recipient. 

What’s Your Thinking of You Card Purpose?

When it comes to the content, consider the purpose of the message. Are you missing someone and want to reconnect or are you sending it to someone going through a hard time and want to offer support? If you have become distant and your note is intended to reconnect and restart the conversation, you may want to address why the lost connection (without placing blame). Some examples: It’s been a while…, sorry we lost touch…, I think about you often. If your note is to offer support to someone going through a difficult time, opt for a message that balances empathy and acknowledgement of the difficult situation. Some examples: I know you are going through a difficult time; I am sorry you are having to deal with {XYZ}. If appropriate, you can follow the supportive message with an offer for tangible support (but only if you are genuinely going to follow up). Some examples for general positive support: sending positive vibes; you are stronger than you know; sending hugs and comfort.

Adding a Personal Touch

For an added personal touch, if you have some inside joke or phrase that will bring a smile, feel free to add as appropriate. Some examples include a favorite movie or book quote, music lyric, affectionate nickname or other inside banter that you share. If humor is your thing, you can always offer something funny, but only if you and the recipient are on the same page and it will be taken the right way. Remember that written messages are far more at risk of being misinterpreted than anything you say in person.

Finally, if there is some action or response you hope to incite with the note, consider opening the door with a few inviting words. Examples include: “Let’s catch up soon”, “Text me if you are feeling up to a call”, or “I see me, you and coffee in our future. What do you think?”.

Some Inspiration and Special Considerations

To take the pressure off, it is always a good idea to draft your thoughts in your phone or on scratch paper first – that way it doesn’t have to be perfect the first time (and leave you with a $6 card in the trash).

Some Special Considerations for a Thinking of You Note to Someone with Cancer

If the person you are reaching out to has cancer or is going through a difficult time, be careful not to fall in the trap of saying things that are dismissive or might come off wrong. You can check out our blog on what to say / not say to someone with cancer to see some examples that help you avoid these pitfalls. Below are a few examples for a Thinking of You card to consider.

Some Helpful Thinking of You Card Examples

General Support Note (neighbor, classmate, co-worker):

  • I can’t imagine what you are going through. I hope this card brings a smile, peace and strength.
  • I can’t imagine what you are going through. I hope this card brings you a smile and brightens your day.
  • I am sorry you are going through such a difficult time. I hope this card brings you a smile and brightens your day.

Friend or Family Support Note:

  • I am sorry you are going through such a difficult time. I can’t imagine how it must feel. I am thinking of you and hope this card brightens your day. Wishing you better days ahead.
  • You have been on my mind a lot. I hope this card brings you a smile and brightens your day. Sending hugs. Text me if you are feeling up to it. I would love to catch up.
  • It’s been a while! Thinking of you and sending along a smile to brighten your day. Text me if you are feeling up for a visit. I would love to see you.

In Summary

In summary, keep it short, simple and appropriate. If you still need assistance with the Thinking of You note, you can always search online for ideas. There are lots of great examples out there.  If you just can’t find the words or right sentiment for someone with cancer, check out Em and Friends. Founded by a cancer survivor, they have a great selection of empathy cards, and there is bound to be at least one card with the perfect words. Good luck and try not to let your fear of saying the wrong thing get in your way.  A simple note with your thoughtful words will make a difference.

A Letter to Parents of a Young Adult Diagnosed with Cancer

Seven years ago today, Kirsten called with news that changed our lives forever. I still have the text exchange on my phone from July 26, 2015. She was away at college, very sick with what she thought was the flu, and a caring friend was driving her around trying to find an urgent care facility that would see her (i.e. accept her insurance). The situation was getting desperate when she texted me for help. As I frantically searched for a location in her area online, another text came through…

“Did you figure it out yet? I am f*king dying here.”

Ugh. Little did we realize. After giving up and telling her to go to the emergency room, I would wait anxiously for two hours before we would hear from her again. That call is the one that will bring parents to their knees. “The doctor says I have leukemia, and he is trying to find a hospital that has beds available. He said I need to go right away.” 

From Kirsten’s diagnosis to the tragic loss, life was disorienting, chaotic, emotional, and exhausting. We felt like we were constantly climbing the cancer learning curve, with so many lessons learned along the way. What I would have given for my future self to offer a few helpful tips before stepping into Kirsten’s hospital room for the first time later that night. 

Over time, we all become experts of our own unique experience with cancer, so my hindsight may have its limits. But in memory and in honor of Kirsten’s experience and the challenges we experienced navigating the ups and downs as parents of a young adult with cancer, I offer the following advice to other parents who have recently been informed their (young adult) child has cancer. 

Parents, find a balance between giving care and giving space

As a parent, when your child is very ill, no matter what age, it is natural to want to do everything you can to protect them. But for a young adult, that can sometimes feel smothering. Have the awareness and take the time to ask them how they want to be supported. Recognize when your care is helpful and when it might feel like too much.

I often felt like I needed to be in the room with Kirsten in case something bad happened. But bad things may happen whether you are there or not, so for your mental health and theirs, find time to take for yourselves (and give them alone time). When you are in the room with them, they may not be able to truly act and feel like themselves.

If they were an independent young adult before the diagnosis, it can be very frustrating to lose that sense of freedom and control. Yes, they will need your help. But give them control where you can, even if it is just giving them a choice about what they want to eat, when they want some alone time, or who they want to visit (or not), etc. When Kirsten’s friends came to visit, we stepped away but let her know we were a text away if needed. 

Parents, do what you can to mitigate physical and emotional isolation.

One thing that has become very clear over the last seven years, the health risks from isolation can have lasting effects. Look for the signs, and work with the psychosocial team to mitigate the impact where possible. Isolation is more than just being alone in a room. It can be felt when they can’t express how they are feeling, when they are unable to do normal activities, and when they don’t have access to peers with shared experiences. And when we apply labels like “you are strong” or “you are an inspiration,” they feel they have to live up to the label, preventing them from sharing how they are really feeling.

By providing a safe space for young adults to share their emotions – name them, understand them, and process them – they can cope and move forward. So when they are sharing how they feel, try not to change the subject, attempt to fix it, or be dismissive. All of those responses invalidate their feelings. Also, there are some topics they need to talk about, but you or other members of the support team might not be the right audience. Depending on the topic, other peers, a trained health professional, or therapist is needed. The best help you can offer in those situations is to ask how they need to be supported and then help them find those other resources.

A word of caution, hospital privacy rules can be a major impediment to meeting others going through a shared experience. Often they are just down the hall, but you will never know. Remember, YOU have control over your own privacy wishes – the best way to meet others may be to give the hospital staff permission to let others know you are there and want to meet. Provide it in writing if needed. Kirsten would do the same thing to seek out other patients. As a consenting adult, she would provide her cell phone number and give the doctors and nurses permission to share it with anyone her age who wanted to meet in the hospital. The rest was up to the recipients to follow through. Your mental health depends on connection and having outlets and people to talk things through, so find ways to make it happen. 

Parents, respect their boundaries and right to private conversations with their medical team.

Let them be the ones in control of the speed and direction of information flow with the health professionals. Their body, life, and future are at stake – give them the opportunity to have full access to the information that affects their future – they should feel comfortable speaking freely, asking questions, answering honestly, and being involved in the decision-making process. Also, respect their privacy boundaries – and try to have the awareness to know when conversations head in that direction and offer to step out without being asked.

And this can’t be emphasized strongly enough…if it gets to the point where they ask you to step out of the room, do it without making them feel bad. It takes courage to speak up, and they need to feel safe making that request. Remember, it is not personal, and it’s not about you. Private topics can include family planning and fertility preservation, sexual activity, and lifestyle choices. For some topics, like fertility, they may not have thought about it until this moment, but they deserve to know how their treatment will impact their future ability to have a family.

There is nothing worse than feeling like, “why didn’t anyone tell me?!” after treatment is over (or it’s too late to take action). Kirsten was very engaged and curious about her condition, treatment, and how it impacted her future. Due to the severity of her cancer, she did not have the time to consider fertility preservation. Still, the information provided by the medical and psychosocial team helped her gain control over one of her biggest fears – fear of the unknown.

Parents, don’t assume you know what they need, be sure to ask.

As an independent young adult, the last thing they want to feel is dependent on their parents again, but they will need and want your support. Just make sure the support you offer is the support they want. Physical and emotional needs will change as treatment and other factors change. Be mindful and present in the moment when you are with them. It will help you tune in to pick up on the spoken and unspoken cues. That means leaving work, other family stress, financial concerns, etc., outside the room when you can.

But even when you are “dialed in” after spending months together, you will still get it wrong. It’s inevitable. But by taking the time to ask the simple but important question, “How can I support you today?” you are allowing them to regain control over what they can control, and in the process, you are getting them what they need. They may not always have an answer (which is okay too), but at least you extended the courtesy of asking. 

Parents, where possible, preserve normalcy, including activities, family time, and routines.

When a diagnosis happens, it’s all hands on deck to save a life, and all focus shifts to the person with cancer. It’s a marathon, not a sprint, and that long-term focused attention can create collateral damage to other family members and relationships. As soon as possible, check in as a family and establish some important ground rules to keep the lines of communication open, find routines that you can sustain, and identify activities that are important to maintain.

Siblings are often asked to take on extra chores, help with school, and sometimes even pick up a job to help with finances. They may sacrifice activities with friends or school milestones because they feel the need to always be strong and mindful of their sibling with cancer. Unfortunately, jealousy, resentment, frustration, and isolation can build up over time, and they will feel isolated, and their mental health will suffer. Give them breaks, have one-on-one time with them to talk and allow them to do special activities. Make sure they still get to live life and have time to enjoy friends.

And for spouses or life partners, make time for each other as well. Plan your own private time away from the hospital together to talk and reconnect. Remember, your child will also want their quiet time, so this is a great opportunity for everyone’s self-care and mental health. 

Parents, watch for signs of financial stress and guilt.

The physical and emotional toll of cancer is bad enough, but the financial damage caused by cancer is also devastating and often hard to recover from. Cancer treatment and all of the secondary costs, including lodging, food, and alternate care for family, can add up FAST. When Kirsten was first diagnosed, we had no idea what to expect, and that one-week hotel reservation turned into a three-month extended stay – and it was out of network for health insurance. And since Kirsten was an adult being treated in the children’s hospital, none of us had access to any available services that would have helped offset those costs.

In the three months we were displaced, we would burn through nearly $40K of non-reimbursable expenses – just for lodging! That doesn’t even scratch the surface of the bills I saw go back and forth between the hospital and the insurance company. Without insurance, everything we had saved for the last 30 years would have been gone by the time treatment was over. My husband was between jobs, and we had no idea what would be approved or denied during treatment. Only after Kirsten was transferred back to San Diego would we become aware of just how stressed she was about the cost of her treatment and her concern for how it impacted all of our futures. That is a heavyweight for a young adult with cancer to bear on top of everything else. 

Parents, asking for and accepting/declining support is stressful, but it doesn’t have to be.

Support stresses everyone out at some level. Those in your circle who want to support worry about calling at a bad time, offering the wrong thing, or making things worse, not better. Remember, people want to help, and sometimes all they need are clear directions. And when you are the one in need of support, there is the stress of being a burden, seeming needy, weak, or incapable of caring for your own family, or on the flip side, not being in the mood for the support that is being offered and feeling guilty declining.

So much energy is wasted on the stress of communicating needs and offers of support. I regret not accepting the offers from friends and family. It would have given us welcome relief and the support system the joy of feeling helpful, making a difference, and providing comfort when someone needed them.

Reducing this stress is easier said than done, but one possible tactic is to make a list of all the things preventing you from being present for a loved one that you find yourself thinking about but don’t have the time to do. Post that list (or have it ready to share when people call or text) and let your network pick and choose what they feel comfortable helping with.

When you decline offers for support, provide constructive feedback that allows the support network to make helpful improvements for next time. Things like exhaustion, diet restrictions, changes to smell or taste, and other sensitivities are all perfectly acceptable reasons for declining or requesting an alternative. “Thank you for the offer. I’m not feeling well today. Can we reschedule for another time?” or “I appreciate the offer to bring ___, but a better alternative would be ___.” Honest and thoughtful guidance will make it better for you and them next time. 

Parents, find a method of communication that works for you and them.

The tools you need to communicate with family may be very different from those you need to communicate with their young adult friends. Find the tools and resources that make life easier, not harder, to keep everyone updated and engaged. There are lots of resources out there. Ask the care team and other caregivers and patients to find out what they use.

Respect privacy, and make it clear to others what they can or can not share. You don’t have to personalize every email – people understand and appreciate any updates. It also opens the door for them to reply when they might otherwise avoid connecting for fear of disturbing you. Also, consider how your updates will affect young adults reading it for the first time. For many, the news, and even the updates, can feel very scary, and have them worrying about death and even questioning their own mortality.

It is okay not to provide updates until you have more information. Avoid throwing the word cancer out there and then going radio silent for days. Only share information with people that you know and trust. And don’t be afraid to remove or block people that feel toxic or are less than helpful. Information sharing is first and foremost to help people provide support and comfort. If they create more work and stress for you than comfort, it is okay to take a break from connecting with them. 

Parents, be patient, be kind, and find forgiveness.

Being in close proximity for extended periods, mixed with fear, uncertainty, loss of independence, and friendships combine to turn life into a giant pressure cooker. The stress is enough to end relationships, break up marriages, create long-term resentment amongst siblings and parents, and unfortunately, contributes to all kinds of physical and emotional baggage down the road. It will be hard work to keep it together sometimes, but for everyone’s sake, do your best to act with kindness and when that fails, gather the courage to ask for and find forgiveness.

When feelings start to escalate, breathe. Have the self-control to take a break and walk away (but don’t storm away). It doesn’t do any good to argue and negatively impacts their health and yours. The closer we are, the more comfortable we are to vent and even say hurtful things. Hold the space for each other to express those feelings and try not to take them personally. Mistakes will be made but do your best. That is all anyone can ask

Keep your head up. Take care of yourself and each other. There will be good days and bad days, but every day you get to spend with each other is a gift. Many things about cancer are out of your control. So don’t waste time worrying about those. What you do have control over is how you choose to live each day and how you choose to treat each other. Do your best to make every day a little better.

Want more?

Cancer and the Holidays: 5 Tips That Will Improve Everyone’s Experience

The holidays are typically seen as a time to celebrate, be with family and friends, exchange gifts, and honor religious or other cherished traditions. When a cancer diagnosis enters the picture, patients and their caregivers can feel disconnected, isolated, and out of sync with everyone else. There can be a lot of extra stress and uncertainty about what’s ahead, wanting to be part of the celebration but knowing that things won’t be the same this year, and feeling pressure to put on a happy face when they may not be feeling it. And for supportive family and friends, they may struggle with what to do and say and how to celebrate when it might feel selfish to be joyful. 

Cancer takes so much from our loved ones. Don’t allow it to take away the relationships and special moments we have to spend together, especially during the cherished holidays.


Support Squad Webinar Recap

In our fifth episode of the Support Squad Webinar SeriesCancer and the Holidays: What to do when it doesn’t feel like there is much to celebrate, we discussed how the experience looks different depending on where they are in their cancer journey, the importance of clear communication and expectation management, and offered some tips and strategies to reduce stress and redesign the holidays so they are the best they can be given the circumstances. 

We had the chance to hear firsthand from young adult cancer survivor Chiara Riga about her experience with cancer in the midst of COVID-19, from bereaved caregiver Abby Westerman about her struggles both during her 20-year-old daughter’s cancer treatment and during the holidays since she has passed, and from AYA cancer patient advocate Kara Noskoff on the many ways to bring “home” into the hospital, particularly during the holidays. Listen to the full episode here.

Tips to Improve the Holiday Experience

Tip 1: Be Present, Not Perfect

Striving for holiday perfection introduces a lot of added pressure and stress for families impacted by cancer who may not have the energy or resources to achieve this unreachable standard. The secret to creating a more meaningful and less stressful holiday? Be present, not perfect

Ensuring loved ones with cancer feel included, seen, and heard, and asking them who they want to see, what activities are important, and where is the least stressful place to celebrate will result in a fulfilling, meaningful, and memorable holiday. The three key elements to being present and improving connection and support apply equally well when planning for the holidays when cancer enters the picture. 

  • Understand what your loved ones are going through. 
  • Clearly communicate needs and manage expectations. 
  • Work together to provide support

By understanding their experience and challenges and focusing on what is most important to our loved ones impacted by cancer, a new holiday plan can be created that offers the chance for new traditions and memories ready to be made.  

Tip 2: Understand What Your Loved Ones with Cancer are Going Through

Depending on where each person is with their cancer experience, the needs and holiday adjustments will look different. If they are undergoing treatment, there may be physical and emotional changes like:

  • Sensitivity to certain foods or smells
  • Compromised immune system – at higher risk when exposed to people who are sick

They might also be stuck in the hospital, which can be especially difficult during the holidays when all they want is home. Find ways to bring “home” holiday traditions and normalcy to them and involve them in the process.

If they are no longer undergoing treatment, they may be adjusting to their new normal. However, they may still have residual effects, including anxiety, depression, physical changes, mobility limitations, or reduced energy. They may also be focused on moving forward and want to be more involved in the holiday plans without being babied.

If the person with cancer did not survive, their family and friends might be struggling with grief and loss. The holidays can be particularly difficult and triggering when that special person is no longer present.

Whether you are planning the celebration or are a supportive family member or friend, it’s essential to understand what they are going through, what is creating stress, and what concerns or limitations exist to help reduce stress and give them the normalcy they desire. 

Cancer and the Holidays

The post “Navigating the Holidays: 5 Things Cancer Patients Wish You Knew” provides several helpful reminders from the perspective of the cancer patient/survivor:

  • “I don’t want the holidays to be all about my cancer. They want normalcy and to enjoy time with their special people.


  • “Don’t baby me. They are not broken. Treat them like a person, not a patient.


  • “Go ahead and ask. I know you want to. Ask, but don’t dwell on it. There are lots of other things they enjoy talking about!” 


  • “Just enjoy the little moments with me. Be present. Time is the most important thing. Enjoy the people in your life!”


  • You can still be happy. In fact, I would prefer it. You are not selfish for talking about you. Don’t feel guilty about the good in your life.”

We would add the following for bereaved caregivers, family, and friends: 

“Let me keep my loved one’s voice and memory in the conversation.” 

Talking about loved ones can be triggering, but not talking about them can feel isolating – like everyone has moved on and forgotten themWhen the loved one’s name comes up, don’t be afraid to talk about them, and avoid changing the subject. Be aware, read the room, and hold space when it is clear that a memory is important or emotionally triggering. Your support and understanding will mean a lot. 

Cancer and the Holidays

(In loving memory of Kirsten Westerman)

Tip 3: Clearly Communicate and Manage Expectations

Good communication is vital to an improved holiday experience. Be clear on specific needs, concerns, and priorities for the holidays. Think of it this way: If you don’t communicate what is needed, you will get what they think you need. Although some people will be in sync with your every desire, most will appreciate clear guidance on how to support or adjust and will be more than happy to do so. 

And remember, good communication goes both ways. If you don’t know what they want, ask them. A great example is the guidelines for in-person gatherings in the face of continued COVID-19 concerns. Be sure to ask cancer survivors about their concerns and make accommodations accordingly. If they are more comfortable with outdoor gatherings, find a way to make that happen. If attending guests live in households with unvaccinated occupants, ask how they feel about possible indirect exposure. 

Bottom line: Don’t make them guess – it just adds stress.


Cancer and the Holidays

When it comes to the holiday traditions and rituals, work with survivors or caregivers to identify what is most important to them during the holidays and clearly communicate that ahead of time so family and friends can adjust their plans and expectations. If you haven’t seen each other in a while, prepare them ahead of time for any changes that might catch them off guard. If you are a caregiver, let them know your emotional status and where you could use some help. 

One approach is writing a Cancer Letter to family and friends that is authentic and reflects your situation and concerns. It can be a great tool to address the elephant in the room, provide power and control over the narrative, and help introduce and navigate the alterations to the holidays, mitigating uncomfortable discussions during get-togethers. Letting people know ahead of time creates realistic expectations and lessens any awkwardness someone might feel if they react with surprise. 

When it comes to boundaries, don’t think about what you “should” be doing, but rather what you need to do to protect your mental and physical health. If you have any special needs to be addressed, make sure they are known in advance. This can include:

  • Accessibility
  • Mobility
  • Dietary needs/limits
  • Hygiene/protective equipment needs
  • In-person gathering concerns/limits
  • Rest/quiet spaces to retreat 

Anything that will make your experience more comfortable and less stressful should be shared. Decide in advance how much information you want to offer, and consider preparing answers to uncomfortable questions they may ask so you aren’t caught off guard. It is okay to set limits, say no, and ask for help. Be honest with yourself and your family. Being clear about needs or asking for help is not a sign of weakness. People want to be supportive and just need simple guidelines or instructions, so give them that chance with clear information. Finally, don’t feel guilty for declining requests or changing plans. People will understand.


Tip 4: Define Priorities and Refine the Holiday Rituals

Traditions and rituals are important, and while they can be comforting, they can also create an unrealistic vision for the “perfect” holiday. With a new perspective on life, some things may no longer feel important or have the same value they once did. Some can even be triggering and bring up emotions that are still fresh. Not all activities will be as easy as they once were. Assess and prioritize the activities and people that are important and focus on those. Allow adequate time and make adjustments so they are still doable. Be okay with change. Remember, it can lead to new experiences, new memories, and new opportunities for growth.  


Cancer and the Holidays

To reduce stress, something has to give this holiday, but what? How do you decide what is important and what can be skipped (or delegated to a supportive family member or friend) this year? Distill your rituals down to their essence – why is that particular activity important? Usually, the activity is not what’s important, but rather the value is in spending time together and creating memories. If that activity is too tiring, brainstorm alternatives that give you time together without the same feelings of exhaustion.

Check out redesigning the holiday, to learn the five steps that will help clarify where the focus should be this year.

  • Try to focus on enjoying the new traditions and special moments, rather than how cancer has changed a holiday or special occasion. 


  • Be realistic about what you can do. Schedule activities when you have the most energy. Allocate additional time to prepare – for example, cook ahead and freeze meals. If it is easier to do certain things online – do it! You can online shop, order food and have it delivered, etc. 


  • Find the right balance between celebrating with family and friends and spending time on your own. 


  • Give yourself permission to pace your activities and to decline an invitation or two so that you have the energy to enjoy the gatherings that are most important to you.


Tip 5: Involve the Support Squad in the New Plan

Once family and friends are aware of the new holiday plans, they may have additional questions about how they can help, what they can bring, gift ideas, etc. Remind them of what is on the buy/don’t buy list due to cancer-related sensitivities. 

Remember that presence, making new memories with special people, and overall normalcy are often valued over gifts. When selecting gifts, practical things that will make a difference in their quality of life are a safe bet but be sure to ask what is important to them. 

If they are in the hospital or can’t attend the gathering at the last minute due to health concerns, prepare a separate meal for them and have it delivered. They will appreciate feeling included and loved even though they could not be there in person. 

In Summary 

Every situation is different, but implementing the simple tips above will create an inclusive, meaningful, and memorable holiday. Understand what they are going through and what will help reduce stress. Keep it simple – only do what is doable and important. Focus on being in the moment with each other and enjoy the holiday celebrations in whatever form they take, whether in-person or virtual, big or small.

Follow your loved one’s lead during conversations, and hold space when things get uncomfortable or emotional. If your loved one can’t make it to the holiday celebration, find ways to bring the essence of the holiday to them so they feel included and remembered. Be open to change and new activities – it is the opportunity for creating new memories. 

The Bottom Line: Seek presence, not holiday perfection, with family and friends. You will be giving each other the best present of all! 

When Words of Gratitude Are All We Have

It was October 18th, 2015, the day before Kirsten was to be life-flighted from Stanford hospital in Palo Alto to Rady Children’s hospital in San Diego, where she would spend the remainder of her days as a cancer patient. We had just spent the last three months in the care of not just health professionals but our extended family, and Kirsten felt palpable anxiety and urgency about creating personal thank you cards and arranging gifts to leave behind. She knew it would be a while before she could return to thank them in person.

Kirsten was in the middle of her treatment, still neutropenic and broken-hearted, that she was less than 24 hours away from leaving her friends and extended family in Palo Alto, potentially forever. Everything was happening very quickly once we got the surprising word that her transfer was not just approved but imminent. There were a lot of things that had to be taken care of, but there was one thing that seemed to be the most important to her, and we had less than 24 hours to get it done, and she knew exactly what she wanted to do. She shared her vision and instructions with me, and I was on a mission to get everything needed.

Making time for gratitude

List in hand, I was off to the stationary store to get the materials to create handmade cards and then to the grocery store for ingredients for the homemade treats she often made for her friends during better days pre-cancer. This wasn’t going to be a quickly put-together “thank you.” It was intended to be thoughtful, personal, and heartfelt. As I was running the errands, I would periodically text her images of papers, decorations, colors, and food items to make sure I was getting everything just right. She wanted it to be perfect.

After Kirsten’s cancer diagnosis, the lotus flower had become her personal symbol for what she had endured, and it was to be the centerpiece for the cards we were about to make. She had researched different designs online and set out to create a design template that I would replicate for each of the special friends in the hospital. It was already dinner time, and we had to have everything complete before 6 am since she would be on a plane later that morning and wanted to personally deliver them to as many people as possible.

We worked tirelessly together – but apart. I was at the hotel making giant pretzels dipped in white and milk chocolate and covered with crushed candy bars. Next was the process of cutting out and assembling the lotus flower cards. Meanwhile, she was busy in her hospital bed typing her personalized notes on her laptop. She was fighting nausea, chemo brain, and endless interruptions, but she was determined to finish the task. We stayed connected throughout the night and into the early hours of the morning, periodically texting, checking in, encouraging each other, and most importantly cracking a few jokes to keep us laughing, awake, and on task under stressful circumstances.

She emailed me the draft letters a little after 2 am, and I was blown away by what she sent. Fighting back tears as I read each note, the love and heartfelt gratitude leaped from the pages. What I was not expecting was how her words shined a light for the first time on just how much she worried about the impact of her diagnosis on our family. In that moment, the gravity of her diagnosis became clear. Despite chemo brain and nausea, she created beautiful, thoughtful, articulate notes of gratitude, and I was never so proud and honored to insert these notes into the handmade cards.

It was past 3 am when we exchanged our final texts for the night. We were exhausted but also exhilarated by the products of our late-night teamwork. Our minds were clear, and the important work of documenting her gratitude was done. I think we both passed out and had the best 3 hours of sleep possible under the circumstances.

Morning came all too quickly as I popped out of bed and carefully packed the car with the treats, cards, and gifts and headed to the hospital. That precious cargo was the punctuation mark on the worst three months of her life, made better by people that cared deeply for her. As I brought the items to her room, I instantly saw how proud and excited she was to see how her vision had come to life. It was just how she imagined it. As she handed out the cards and sweet treats, her love and heartfelt appreciation for those that had cared for her was clear.

With the most important task of the day behind her, the time had finally come. The paramedics were ready to prepare her for the long trip to her hometown hospital in San Diego. As she was wheeled down the hospital corridor for the last time, she heard the loving calls from the nurses and staff on duty one last time. “We will miss you, Kirsten!” With her favorite AYA support staff by her side for that final ride to the parking lot, I walked a few steps behind, feeling a wave of emotions. For her, I know she felt anxious, sad, hopeful, and so very grateful for the people that helped her make it this far.

Don’t let words of gratitude go unsaid

I learned an important lesson from Kirsten that day…whatever it takes, don’t let your words of appreciation go unsaid. Whether it is in life’s most dire situations or the mundane day-to-day, try to find, celebrate and acknowledge the good that happens around you. Seize the moment with the urgency and drive of knowing you may never have a second chance to express what is in your heart. Let those special people know that their actions meant something. Be specific about how they changed you, made you feel better, safer, less anxious, seen, heard, supported, more connected, and less alone. Words can sometimes feel like they are not enough, but when they come from the heart, they can be inspiring, uplifting and are often exactly what is needed.

Excerpts from Kirsten’s Gratitude Letters

  • Thank you for being an amazing doctor and going beyond what is asked of you. I could tell you really care about all of your patients and tried to make a connection with each and every one of us.


  • I always enjoyed when you came by because there was never a dull moment and you were always nice enough to laugh at all my jokes. You took a lot of pressure off of my family, which was so important to me.


  • You were really there for me when you saw that I was upset and I appreciate that.


  • You have been one of my biggest supporters and I love that you are working on making a program for young adults. Being here, I’ve realized how important those types of connections are and really admire that you have been working so hard to make us feel more comfortable.


  • I really can’t thank you enough for how much you have impacted my family by making sure everything was always taken care of and reducing the stress my family has been through.


  • The amount of passion and love that you have for your patients here is incredible and something I admire. Thank you for introducing Crystal and I because it really sparked something here. Even though we broke the rules, it helped the nurses and doctors realize how important it is for the patients to interact and have a friend here.


  • You are one of my favorite nurses and you honestly made this whole process for me so much easier. I always looked forward to having you as my night nurse because there was never a dull moment with you and our conversations helped take my mind off of this whole situation.


  • You really made patients feel like people rather than just another kid with cancer. You have a big heart and were always willing to put up with my lame jokes and listen to me when I really needed someone to talk to.


  • I’m so glad that I was able to have a friend like you in here. Even though life hasn’t always been easy, you have been so incredibly strong and honestly been someone that I look up to.

Want more?

How an Occupational Therapist Supports Cancer Survivors

An Interview with Kelly Watson

Meet Kelly Watson. Kelly was Kirsten’s best friend since first grade and was a loyal supporter throughout Kirsten’s journey. Kelly continues to be an amazing supporter for the young adult cancer community as a founding board member of the b-present Foundation and engaged volunteer supporting the b-present programs and events. Kelly recently completed her degree in Occupational Therapy, and now supports patients in need as a registered and licensed occupational therapist (OTR/L).

Kirsten Westerman (left) and Kelly Watson (right)


If you are like me, you may not know about the important role the Occupational Therapist plays in the rehabilitation of a cancer survivor. I sat down with Kelly to set the record straight on what an Occupational Therapist does, and the important role OTs play in supporting cancer survivors, helping them get back to living their fullest life.

Abby: Hey Kelly! Thanks for chatting with me. Before we talk about your current occupation, would you mind sharing a little about your friendship with Kirsten, the inspiration behind b-present?

Kelly:  Absolutely! My friendship with Kirsten began in first grade when she and her family had moved to San Diego. We were both shy little children but immediately hit it off. Kirsten and I had continued to have a strong, sister-type friendship ever since. I will always cherish the friendship we had and the memories we made. Kirsten was truly an amazing person and possessed great qualities that we have tried to translate into the inspiration behind b-present. 

Kirsten Westerman (left) and Kelly Watson (right)


Abby: As a supporter of a young adult cancer patient, what is something you have learned that you wish you knew when you were first called on for support?

Kelly: I wish I would have known how to be a better supporter in general, honestly. Even though Kirsten was my best friend for such a long period of time, I often found myself not knowing what to say, how to act, or even how I should entertain her during our visits. Thankfully, b-present has provided several resources for concerns very similar to mine and given me and others advice and tips on how to address these concerns while being a supporter. 

Abby: What inspired you to get an OT degree?

Kelly: I always knew that I wanted to help others and give back in some sort of way. I really fell in love with the idea of occupational therapy after learning what the career truly encompassed. With OT you get to help others restore their functioning of day to day activities (i.e. showering, getting dressed, going to the bathroom, etc.) that many of us participate in so instinctively and never realize we may need re-learning them after a traumatic injury, illness or disability. I love the holistic approach the career offers and being able to help others increase their quality of life through meaningful rehabilitation. 

Abby: When I hear the title “occupational therapist”, I have always thought it was someone who helps a person that is injured on the job and needs to heal to get back to work. What exactly does an occupational therapist (OT) do?

Kelly: An occupational therapist is someone who works with various populations, in several settings, and essentially strives to promote an increased quality of life through rehabilitation. We thoroughly analyze an individual’s “occupations”, which you are not alone in thinking it only has something to do with someone’s job. Occupations are any activities of daily living that you enjoy doing day in and day out. 

Abby: How would an OT specifically support young adult cancer survivors?

Kelly: With a cancer diagnosis, young adults will likely experience drastic changes and prevention of participating in their daily routines, roles, and activities. They may be facing several functional deficits including, but not limited to, fatigue, muscle weakness, cognition, and a decreased ability to perform daily tasks as independently as they once were. Mental health also plays a vital role in this diagnosis as young adults with cancer may have increased feelings of depression, isolation, anxiety, low self-esteem, and body image.

Abby: What are some of the different interventions provided by OT’s that help increase overall well-being and achieve maximal function. 

Kelly: Patients that go through harsh rounds of chemotherapy and many other treatments may benefit from energy conservation training, activity modification, and the ability to monitor energy patterns. Moreover, OT interventions can assist with skills ranging from getting oneself dressed/undressed, taking a bath/shower, using the restroom, to the more complex activities such as organizing a daily schedule, paying bills, cooking, cleaning, taking care of children and/or aging family members, or pets. All of these are very important

Abby: Once you assess the patient’s needs, how do you help them get back to life?

Kelly: Adaptive strategies are designed and used to best suit that patient and help them compensate for any impaired function whether it is physical, mental, or cognitively. Additionally, OT’s are fully equipped to provide exercise programs that include exercises, stretching, massage, and other modalities to help improve muscle strength, range of motion, and elasticity. 

Abby: You and some of your peers started a website to help other new OT’s navigate the profession. What inspired you to start that website?

Kelly: We were inspired to do that to help other OT’s and OT students by sharing with them real, raw, and honest knowledge that we had wished we received during school/post-graduation. Our goal is to provide resources for these individuals that we think would be really helpful in transitioning from graduate school to landing that first job! 


View this post on Instagram


We are four OTR/L’s who met in grad school and have found a common love and need for doing our part to nourish the field of Occupational Therapy. We’ve be inseparable ever since! We created OT Unfiltered to help students and new grads just like we once were, navigate the world of OT with all the concepts and guidance we wish we would have had, while going through the process. We love a good visual and hope you are able to connect and relate through our experiences. We want our interaction with you to be fun, relatable and 100% honest. We are not here to sugar coat the facts, we are here to expose the realistic expectations and help you with your OT journey with all the facts! We are by no means perfect OTs and nor do we pretend to be. We have struggles and we have triumphs! We get all the ups and downs, the emotions, the stressors of being in grad school and navigating a profession in a time of a world pandemic, with little guidance. WE GET IT. So let us help guide you through your journey and make your life a little bit easier in ways we would wished resources would have been available to us! We love all our fellow OTs, we support you and we are here for you! Keepin it raw, real & honest, Lauren Arriola, Jill Kenbeek, Hannah Noble and Kelly Watson

A post shared by OT Unfiltered (@ot_unfiltered) on

b-p: What is the most rewarding part of your job?

Kelly: The most rewarding part of my job is seeing my patients/clients happy with their successes. I love seeing them improve no matter how big or small it might be and that feeling of confidence and motivation they gain. 

Abby: As a supporter of a young adult cancer patient, are there any lessons you have incorporated into your new profession as an occupational therapist and how you interact with patients?

Kelly: Yes! I have learned to treat each patient as an individual and understand that they have a life and are a person outside of their diagnosis or condition. I have learned to treat others with empathy, but also not pity them for the position they may be in. Instead, provide them with the most support and encouragement that I am able to. 

Abby: Thanks so much for sharing your perspective Kelly, and for dedicating your career to helping others get back on their feet! Any final thoughts?

Kelly: I hope you found this quick glimpse into the life of an OT working with cancer patients interesting and informative! And that you may now recognize how this holistic rehabilitative discipline can assist individuals with a cancer diagnosis in achieving maximal functional performance (physically and mentally), independence, and increased quality of life.

Want more?

The Support Report with b-present – How Support Changes Lives

Our new podcast, The Support Report with b-present, is hosted by our very own Justin Peters. Each month we share real stories from young adults and dive deep into how support changed their lives. We explore their challenges, triumphs, and everything in between. We want the Support Report  to inspire, entertain, and empower you to create your own stories of support and presence for others within your community.

The Need

Now more than ever, people are experiencing the need to connect and realizing how much it hurts when they are not. They need to know that they are not alone in their struggles and that there is someone beside them to lean on, laugh with, and learn from. However, providing support is not always easy, and the moments when someone needs us most may also be the moments we have to dig the deepest to get through. But know this…

Those moments matter. 


When a young adult faces a life-altering experience, their health becomes dependent on the presence of others. Whether it is a diagnosis, loss of a loved one, mental struggles, or grief, the support of a loved one is vital. Having supportive people in our lives helps us through tough moments so we can enjoy moments of relief, joy, and hope. 

Let’s talk about it

The Support Report exists to help you develop empathy and compassion that leads to improved connections. By self-reflecting and applying what you learn we hope to help you become better supporters for the future. And we want to inspire you to create change in your own lives and communities by volunteering your time and talent, advising or starting organizations, and creating products or services that solve problems you have experienced or have the means to solve. While you may not be able to change the past, you can learn from others’ experiences and find new ways to be present with purpose and change the future for those that need you most.

Check out our current podcast episodes:

Want to be featured on The Support Report?

So how has being a supporter or receiving support changed your life? We’d love to share YOUR story. Email us at [email protected] so we can start the conversation!


Wrapped In Presence | Supporting Patients One Handmade Blanket at a Time

Presence comes in many forms

A life-threatening diagnosis turns life upside down. Patients need to feel connected to the world as they undergo treatment, and know that they are not facing the diagnosis alone. One effective way to achieve this is by providing items of comfort, a reminder of home, and a visual reminder of family, friends, or a community rooting for the patient to finish treatment.


Why is a blanket so special?

If you have ever spent much time in a hospital, you probably noticed it does not feel much like home. When 19-year-old Kirsten, the inspiration behind b-present, was diagnosed with leukemia on July 26, 2015, her treatment required her to be confined to a hospital room for seven months. During that time, we saw firsthand how a soft, colorful blanket could provide comfort, even when no one was nearby. Kirsten received her first blanket from her best friend, Kelly. Kirsten wore that blanket around her shoulders all the time. It was like getting a virtual hug from her BFF whenever she needed it. Kirsten was wrapped in Kelly’s presence.


Kirsten (left) and her best friend since first grade, Kelly (right)


How Wrapped in Presence works…

As we remember Kirsten on the fifth anniversary of her diagnosis, b-present has partnered with Fleece and Thank You, another young adult founded organization inspired by young adults with cancer, to create fleece blankets for children and young adults facing extended hospital stays. We’d love for you to join us!

Simply order your blanket making kits, make the blankets, and either drop them off or mail them to our San Diego location. Blanket makers record a video message that goes with the blanket to the patient, and the patient can send a return video message.



Whether you are a close friend or family member, or a member of the support community, your handmade fleece blanket and personalized video message ensures the patient is wrapped in presence during a difficult time.



Virtual blanket making events

We held our first Wrapped in Presence Virtual Blanket Making Event on August 31st. Hosted by b-present, this event featured a special appearance by Fleece and Thank You CEO Nicholas Kristock and survivor Hannah Thomas who was blanket recipient during her treatment. It was a great opportunity to connect, learn, and create comfort and support for hospital patients in our community that need to know they are not alone.  

If you would like to participate in a future virtual event,  let us know. If there is enough interest, we would love to host more Wrapped in Presence community events. 


Want more?

Oncology Nurses Month – Why ‘Thank You’ Will Never Feel Like Enough

Throughout their careers, oncology nurses will impact thousands of families and lives. They are advocates, friends, extended family, and confidants during a unique and challenging time of life. They defined our cancer experience in unimaginable yet incredible ways. 

Our Experience

I can’t imagine Kirsten’s experience without her nurses by her side. They served a vital role in providing normalcy, support, and companionship when she desperately needed it. They listened without judgment, allowed her to speak her mind, and gave her the space to be her authentic self in her new home. Those simple conversations about normal things mattered, restored hope, and kept her sane and upbeat in a place that could otherwise be very lonely and sad. 

And the nurses knew when to go the extra mile or facilitate connections that put the wind back in her sails. They made time during their busy shifts to walk the halls with her, take a break in the garden with her, or just hang out in her room and joke for a few minutes. They made defining moments like her 20th birthday, and the end of treatment feel special with beautiful colorful posters and singing. 

When her world started to fall apart unexpectedly, they were the trusted friends that spoke to her with compassion and honesty, allowing her to calmly come to terms with her fate. And when we knew there was no turning back, they came to her side to say one last goodbye.

Those countless moments of compassion and support from her nurses brought Kirsten hope, joy, laughter, and in the end, peace. 


The hardest thing we had to do after saying goodbye to Kirsten was saying goodbye to our extended family of oncology nurses. When her experience was over, so was our connection to the only world we knew for those seven months. We understood why it had to end, but it felt like we lost more than a child that day. 

New Beginnings

Since starting the b-present Foundation, I have had the pleasure of reconnecting with this fantastic community, and I continue to learn about and be inspired by how they fight for young adults behind the scenes. It gives me great hope for the future. They navigate the delicate balance between the rules and the humanity they know is needed. They meet and brainstorm how to make things better, sharing ideas and support, knowing they are all fighting for the same cause. 

b-present Foundation young adult cancer support Workshop 2019 | Oncology Nurses Month

Improving the Quality and Impact of the Young Adult Support Network Workshop hosted by the b-present Foundation on November 14 & 15, 2019


After treatment is over, they work tirelessly to provide continued support, stay connected, create meaningful experiences, and new memories for the survivors ready to move forward and conquer the world with their own amazing gifts. Especially during times like these, I can only imagine the challenges oncology nurses face daily. It must be exhausting. Yet they stay the course with courage and compassion, facing the unimaginable time and again, giving each young adult the hope, normalcy, and escape they need. 

‘Thank You’ Oncology Nurses

‘Thank you’ never seems like enough, and today is no exception. To the oncology nurses around the world, we appreciate you, we are grateful for your endless sacrifices, and we can’t imagine what the journey would be like without you by our side.


How to Support Someone in Isolation | Coronavirus Crisis

With the coronavirus (COVID-19) leading to the cancellation of most community, school, and sporting events, our most vulnerable populations are self-isolating, and feelings of loneliness can become magnified. There is so much uncertainty in the world during times of crisis. However, one thing is certain…we’re all in this together, and we need each other’s support to get through tough times. So how can we support someone in isolation? Let’s commit to being there for them. People might be too humble or shy to ask for support or companionship, even if they desire it. Rather than wait for our loved ones to reach out to us, let’s be proactive. 

We may not be able to sit in the same room with a loved one in isolation, but that shouldn’t prevent us from connecting and providing support. Know the guidelines, but this is an opportunity to b-creative with your interactions. And remember there are lots of ways to virtually b-there!

support someone in insolation via text

To support someone in isolation or someone that has visitor restrictions:

  • Reach out via text, phone call, or video chat to check-in. Let them know you are thinking of them and ask how you can support them
  • Avoid saying, “let me know if you need anything,” and instead offer some actionable options like…
    • Feeding/caring for a pet, or taking them for a walk
    • Making or picking up and delivering a meal (you may need to drop it off at the front door)
    • Running an errand
    • Picking up some needed items
    • Helping with time-critical activities (ex: bills or taxes)
    • Offering to babysit a child off from school.


If you are supporting someone that is isolated but still up for activities:

  • Watch a show or movie together with Netflix Party. It synchronizes video playback and adds group chat to your favorite Netflix shows.
  • Schedule a time to play an online game together (ex: Words with Friends, Trivia Crack, etc.)
  • Hop on a video chat like FaceTime or Zoom and challenge them to a game of Hangman, Tic Tac Toe, or Pictionary — get creative!
  • Share a favorite old photo and play the game “What/where/when/who.” 
  • Send a favorite picture or meme that will make them smile. Have fun and put your own captions on a funny image.
  • Visit a virtual museum together
  • Learn more about your friend and strengthen your bond with a fun, informal interview. Here’s a list of silly and serious questions to ask.


If you are supporting someone that is isolated and feeling stressed or anxious:

  • Offer a shoulder to cry on (perhaps only figuratively)
  • Check-in with them frequently and be a good listener. Sometimes the best thing you can do is listen as they voice their concerns
  • If they talk about stressors that you can help with, offer to help
  • Not everything can be fixed, so don’t feel like you need to be a fixer. Just assure them that you will be there for moral support through it all

Have another helpful support tip to add to the list? Contact us to let us know!

Loneliness Poses the Same Health Risk as Smoking 15 Cigarettes a Day

Yes, you read that headline correctly. Loneliness poses the same health risk as smoking 15 cigarettes a day! When I read that statistic, I couldn’t believe it. Loneliness impacts our health and our mortality. An even more disheartening fact is, according to a recent study, loneliness is on the rise, with nearly 2/3 of Americans feeling lonely. The younger you are, the more likely you are to be impacted.

But loneliness is not the same as being alone on a Saturday night. You can experience loneliness even when you are surrounded by people.
I heard a description of loneliness that makes the problem very clear, especially when it comes to thinking about how we can help. It was…

“Loneliness is caused by a mismatch between the quality and quantity of connections we want and those we receive.”


What can we do to help solve this problem?

Be present. Let’s make a promise to each other right now that loneliness won’t be one of the health risks we ever have to worry about.

How do we fulfill that promise?

Commit to being there for those who need us without hesitation. This is particularly important for our loved ones with cancer because their immune system is already beat down by the cancer treatments. Let’s not let loneliness be yet another challenge they must face and overcome, especially knowing that loneliness has an impact on their mortality.


Don’t let them suffer

Would you willingly hand your loved one 15 cigarettes and watch as they smoked every last one? Absolutely not. There is no way we would allow our loved ones to suffer from loneliness if we knew it was equally as harmful to their health as smoking those cigarettes. Yet we somehow let ourselves get in our own way when it comes to being present for those that need us.

So let’s stop with the excuses and make loneliness go up in smoke. Commit to reaching out and checking in. The best connections involve putting the devices down and dedicating our eyes, ears, and heart to the person next to us.

Never underestimate the power of presence…you just might save a life!